Account Setup

for

Pharmaceutical Services

1. Get Registered. Download the Customer Registration Form and Inventory Forms below.

2. Gather the Details.  Fill out the Customer Verification Form completely and the optional credit application

3. Licenses. Provide copies of your DEA Registration, State Controlled Substance License (if applicable) and other State Licenses

4. Send the completed Customer Registration Form, optional credit application and all licenses via Fax (480) 659-2353 or email to compliance@123compliant.com.

5. We will contact you to confirm your information has been validated and your account is active